Gajda Sports Medical Center LTD

Primary specialty

Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X

License

036066049 Issued in IL

Legal business name

GAJDA SPORTS MEDICAL CENTER LTD

Practice address

400 Lake Cook Road Suite 200C
Deerfield, IL 60015

Phone

(708) 352-2392

Fax

(708) 352-2738

NPI assigned

Jan 29, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Karen Dale Gajda, DO

Title

Owner Doctor

Phone

(708) 352-2392

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358812800000",
    "number": "1114063989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 MALDEN AVE",
            "city": "LA GRANGE PARK",
            "state": "IL",
            "postal_code": "605265514",
            "telephone_number": "708-352-2392",
            "fax_number": "708-352-2738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 LAKE COOK ROAD SUITE 200C",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "60015",
            "telephone_number": "708-352-2392",
            "fax_number": "708-352-2738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAJDA SPORTS MEDICAL CENTER LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2013-01-22",
        "status": "A",
        "authorized_official_last_name": "GAJDA",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "OWNER DOCTOR",
        "authorized_official_telephone_number": "708-352-2392",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "IL",
            "license": "036066049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Neuromusculoskeletal Medicine & OMM Physician in Deerfield, IL
• Providers in Deerfield, IL by specialty
• Neuromusculoskeletal Medicine & OMM Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.